Experimental study of the effect of high-strength clogging-resistant permeable pavement (CRP) on the runoff using a rainfall simulator.

Permeable pavements play an effective role in reducing runoff by decreasing the impermeable area. But, conventional permeable pavements suffer disadvantages such as low resistance. To address this, the 'high-strength clogging-resistant permeable pavement (CRP)' has been developed. The present study aimed to evaluate the performance of the CRP model with varying percentages of coverage (A) of 25, 50, and 100%, slopes (S) of 1, 3, and 5%, as well as rainfall intensities (I) of 45, 55, 70, 90, 170, and 200 mm/h. Based on the results, there was an increase in A from 50 to 100% at I = 90 mm/h, decreased runoff coefficient (C) of 18, 15, and 13% at S of 1, 3, and 5%, respectively. At the same I, increasing S from 1 to 5% increased the C coefficient in A of 0, 25, 50, and 100% by 3, 31, 32, and 39%, respectively. Due to the ever-increasing urbanization and the subsequent increase in impervious areas, the risk of severe floods has greatly increased. Therefore, providing solutions such as the CRP model can help reduce flood risks in urban areas. The findings of this research can be used as a guide in the design of high-strength clogging-resistant permeable pavements in urban areas.

Three-dimensional guided lateral window sinus lift and simultaneous implant placement: A dental technique.

Lateral window sinus floor elevation is typically performed blind, and complications may be encountered. Guided surgery can help make the procedure more predictable with fewer complications and a shorter surgical time. The presented technique uses a surgical template for simultaneous implant placement and sinus floor elevation. An implant platform is used for determining the size, shape, and location of the window and the osteotomy depth. The technique uses a Ø5 mm bone profiler with a stop compatible with the surgical guide design to conduct the osteotomy, conservatively guiding the lateral window osteotomy in 3 dimensions.

The Prognostic Significance of P16 Immunohistochemical Expression Pattern in Women with Invasive Ductal Breast Carcinoma.

Background: Breast cancer is the most common malignancy in women worldwide. The p16 protein is a cell cycle regulator and tumor suppressor implicated in several types of cancers. However, its relationship to breast cancer is still unknown. The present study aimed to assess the association of p16 protein expression with clinicopathological features in breast cancer.This study aimed to investigate the anti-cancer effects of different gum extracts on metabolic changes and their impact on gene expression in HT-29 cell. Methods: The study enrolled 100 patients with invasive ductal carcinoma. The samples were collected before any adjuvant chemotherapy, and p16 protein expression was determined using immunohistochemistry. Clinicopathological features were obtained from the patient's medical records. Results: Our findings demonstrated that p16 protein expression increased in estrogen receptor-positive tumor tissues (P< 0.01). However, no significant correlation was found between the p16 protein expression and the other clinicopathological features. Conclusions: Our study demonstrated that p16 protein expression increased in ER-positive tumor tissue from patients with invasive ductal breast carcinoma. However, no correlation was found between the p16 protein expression and the other clinicopathological features.

Nerve Root Metastasis of Breast Carcinoma Detected by Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Scan.

A 35-year-old woman with history of breast cancer was referred to our department for restaging by F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan. Aside from multiple other FDG-avid metastatic lesions, a segmental increased FDG uptake was visualized along the asymmetrically thicker left first sacral nerve root, highly concerning for metastatic disease, which was confirmed by the subsequently performed magnetic resonance imaging. Our case highlights the capability of FDG PET/CT scan in the correct diagnosis of the extremely rare phenomenon of nerve root metastasis as well as the importance of differentiating FDG-avid lumbosacral nerve roots from adjacent skeletal metastases.

Comparison Between the Effect of Intra-Scalar Methylprednisolone and Sodium Hyaluronate in Impedance and Electrically Evoked Compound Action Potentials in Cochlear Implant Patients.

To evaluate and compare the effect of intra-scalar methylprednisolone and sodium hyaluronate on cochlear implants' impedance and electrically evoked compound action potentials thresholds. In a prospective randomized clinical trial, 103 children with pre-lingual hearing loss candidates for cochlear implantation at a tertiary hospital were divided into three groups based on intervention. Intraoperatively, one group received intra-scalar methylprednisolone, the second sodium hyaluronate, and the third group was the control group. Impedance and electrically evoked compound action potentials (e-ECAP) thresholds on long-term follow-up were evaluated and compared in these three groups. Significant decrease in impedance and e-ECAP thresholds were observed in all groups in a 4-year follow-up. No statistically significant difference was observed among all mentioned groups. Impedance and e-ECAP thresholds decrease in the long term, and using topical intra-scalar Healon or methylprednisolone may not significantly affect these parameters.

Intranasal Corticosteroid Treatment on Recovery of Long-Term Olfactory Dysfunction Due to COVID-19.

BACKGROUND AND AIMS: Olfactory dysfunction is a recognized manifestation in patients infected with Coronavirus Disease 2019 (COVID-19). This investigation aimed to assess the effect of mometasone furoate intranasal spray on the improvement of smell dysfunction in post-COVID-19 patients. MATERIALS AND METHODS: This randomized placebo-controlled trial included 80 non-hospitalized adult patients who had persistent anosmia or severe microsmia for more than 4 weeks due to COVID-19 infection. The participants were randomly allocated to the intervention or placebo group to receive mometasone furoate nasal spray or sodium chloride intranasal spray during 4 weeks of follow-up, respectively. The patients' olfactory dysfunction was assessed in terms of visual analog scale (VAS), and smell test score according to the modified version of the University of Pennsylvania smell identification test for the Iranian population. RESULTS: A total of 70 participants completed the follow-up period and were analyzed in this study. By comparing the olfactory scores including smell test and VAS scores, no significant differences were found between case and control groups at baseline, 2, and 4 weeks intervals. However, the change of both olfactory scores at pre to post-treatment intervals and 2-4 weeks was significantly higher in the mometasone group relative to the placebo group. At post-treatment, the frequency of anosmia was 22.9% reduced in the case group compared to the control group. CONCLUSION: Overall, there was no significant difference in olfactory dysfunction between the two groups during follow-up. However, based on the significant between-group difference in terms of olfactory scores changes, it seems that the nasal corticosteroids may be a positive effect on the recovery process of patients who received more than 2 weeks. LEVEL OF EVIDENCE: 2 Laryngoscope, 132:2209-2216, 2022.

68Ga-PSMA PET/CT Scan Leading to Diagnosis of PSMA-Positive Rectal Adenocarcinoma in a Patient With Prostate Cancer.

ABSTRACT: A 59-year-old prostate cancer patient, status post radical prostatectomy, was referred to our department for restaging with 68Ga-prostate-specific membrane antigen (PSMA) PET/CT scan. Aside multiple metastatic lesions involving pelvic lymph nodes as well as the right femoral trochanter, a PSMA-positive rectal wall thickening was detected. Colonoscopy correlation and tissue diagnosis, recommended to rule out accompanying primary malignancy, confirmed the presence of rectal adenocarcinoma. This case signifies the importance of requesting pathological correlation for unexplained PSMA-positive lesions, emphasizing the potential role PSMA ligands may play in detecting occult second primary malignancies, especially synchronous/metachronous colorectal cancers.

Association Between Serum Vitamin D Level and Ménière's Disease.

OBJECTIVES: Ménière's disease (MD) is a well-known inner ear disease; however, the etiopathogenesis is unknown. Several factors may be involved. Meanwhile, vitamin D is reported to have an important role in inner ear physiology. The aim of this study is to evaluate the relation between vitamin D deficiency and MD. STUDY DESIGN: This matched case-control study compared serum vitamin D levels between patients with definite MD and those without it. SETTING: The study was done between August 2018 and December 2019 at Ghaem University Hospital in Mashhad, Iran. METHODS: Twenty-eight patients with definite MD were matched with a group of 84 healthy individuals, regarding age, sex, body mass index, and occupation (indoor vs outdoor). The serum level of vitamin D (25-hydroxyvitamin D3) was measured in both groups. RESULTS: The mean ± SD vitamin D level was 18.9 ± 9.7 ng/mL in the case group and 25.2 ± 13.7 ng/mL in the control group (P = .027). There was a significant difference between the case and control groups according to the results of the conditional logistic regression model (P = .03; adjusted odds ratio, 0.96). In the MD group, 17 (60.7%) patients were vitamin D deficient, 6 (21.4%) insufficient, and only 5 (17.9%) sufficient. CONCLUSIONS: The results of this study show that serum vitamin D level in MD is significantly lower than that of the control group. However, the role of vitamin D supplementation in the management of MD needs further study. LEVEL OF EVIDENCE: 4.

Increased incidence of rhino-orbital mucormycosis in an educational therapeutic hospital during the COVID-19 pandemic in western Iran: An observational study.

BACKGROUND: COVID-19 patients, especially the patients requiring hospitalisation, have a high risk of several complications such as opportunistic bacterial and fungal infections. Mucormycosis is a rare and opportunistic fungal infection that mainly affects diabetic and immunocompromised patients. An increase has been observed in the number of rhino-orbital mucormycosis in patients with COVID-19 admitted to Imam Khomeini Hospital, Kermanshah, Iran, since October 2020. This is a report of the frequency, risk factors, clinical manifestations, treatment and prognosis of COVID-19 associated with mucormycosis infection. METHODS: The medical records of COVID-19 patients with rhino-orbital mucormycosis who were diagnosed in an educational therapeutic hospital in Kermanshah, west of Iran were surveyed. Several parameters were analysed including demographic, clinical, therapeutic and laboratory characteristics. RESULTS: Twelve patients with COVID-19-associated rhino-orbital mucormycosis were identified from 12 October to 18 November 2020. All cases reported as proven mucormycosis had a history of hospitalisation due to COVID-19. Comorbidities mainly included diabetes mellitus (83.33%) and hypertension (58.33%). Seventy-five per cent of patients received corticosteroids for COVID- 19 treatment. The sites of involvement were rhino-sino-orbital (83%) and rhino-sino (17%). Amphotericin B/liposomal amphotericin B alone or in combination with surgical debridement or orbital exenteration was used as the first-line therapy. The overall mortality rate was 66.7% (8/12). CONCLUSIONS: We found a high incidence of mucormycosis among COVID-19 patients. Diabetes mellitus and corticosteroid use were the dominant predisposing factor of mucormycosis. Mucormycosis is a life-threatening and opportunistic infection; therefore, physicians should know the signs and symptoms of the disease so that a timely diagnosis and therapy can be performed.

Cisplatin-Induced Nephrotoxicity; Protective Supplements and Gender Differences

Cisplatin (CDDP) has been widely used as a chemotherapeutic agent for solid tumors. The most common side effect of CDDP is nephrotoxicity, and many efforts have been made in the laboratory and the clinic to employ candidate adjuvants to CDDP to minimize this adverse influence. Many synthetic and herbal antioxidants as well as trace elements have been investigated for this purpose in recent years and a variety of positive and negative results have been yielded. However, no definitive supplement has so far been proposed to prevent CDDP-induced nephrotoxicity; however, this condition is gender related and the sex hormone estrogen may protect the kidney against CDDP damage. In this review, the results of research related to the effect of different synthetic and herbal antioxidants supplements are presented and discussed with suggestions included for future work.

Abnormal Presentation of Choriocarcinoma and Literature Review.

INTRODUCTION: Gestational trophoblastic neoplasms have highly been malignant potential, which usually occurred in child-bearing age women. Unusual feature of this malignancy would be rare, it was important to take in mind the possibility of GTN in different manifestation. Based on the above mentioned, the aim of this presentation would be the management and outcome of a case series of choriocarcinoma patients with abnormal manifestation. CASE PRESENTATION: We have presented four patients, first who initially manifestation with signs of septic shock, the second case with severe gastrointestinal hemorrhage, the third case with postpartum infection and the forth case was a postmenopausal bleeding patient. CONCLUSIONS: In case of metastatic choriocarcinoma with precise history, accurate diagnosis and appropriate treatment have led us to curable results.

Epidemiology of hemoglobinopathies and thalassemias in individuals referred to the haematology research centre, Shiraz University of Medical Sciences, Shiraz, Iran from 2006 to 2011.

Hemoglobinopathies and thalassemias are the most frequent genetic hereditary disorders with an increasing global health burden, especially in low- and middle-income countries. We aimed to determine the epidemiologic pattern of hemoglobinopathies and thalassemias in individuals referred to the Haematology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran, which is the most important referral center in Southern Iran during 2006 to 2011. The most frequent abnormality was ß-thalassemia (ß-thal) minor (24.0%), followed by α-thalassemia (α-thal) trait (10.0%), hemoglobin (Hb) S trait (4.0%) and Hb D-Punjab trait (4.0%). Because this center is a referral center, we detected a higher prevalence compared to the normal population; however, these data could help policymakers and health service providers to better programming for prevention of births affected with Hb disorders.

Blind versus fluoroscopy-guided percutaneous nephrolithotomy: a randomized clinical trial.

PURPOSE: Due to the negative impact of radiation on the patient and the surgical team during percutaneous nephrolithotomy (PCNL), we aimed to evaluate success rate and complications of blind access for PCNL using lumbar notch landmark and compare with conventional fluoroscopy-guided access. MATERIALS AND METHODS: In a clinical trial, 100 patients who were candidate for PCNL, were randomly assigned into blind group (1) and fluoroscopy-guided group (2). In group 1 the lumbar notch was used to guide percutaneous access and in group 2 fluoroscopy performed after needle insertion, Amplatz placement and at the end of surgery. If the access failed, we would repeat puncturing up to 5 times. In group 2, access was achieved using full fluoroscopy guidance. All patients underwent postoperative assessment including kidney-ureter-bladder X-ray and ultrasonography. RESULTS: Both mean access time and mean operation time were statically similar in group 1 and group 2 (3.3 ± 0.5 vs. 3.6 ± 0.7 min and 35.2 ± 4.6 vs. 38.9 ± 4.1 min, respectively). A successful puncture was achieved in 86% and 94% of the patients in groups 1 and 2, respectively (P = .18). Total success rate of procedure was 80% and 88% of the patients in groups 1 and 2, respectively (P = .27). CONCLUSION: According to this study, it seems that blind access is a safe and effective PCNL method, and we recommend employment of this technique by skilled endourologist in urology centers especially for patient with large hydronephrotic kidney.

Ultrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study.

BACKGROUND AND PURPOSE: Gaining access to the pyelocaliceal system in percutaneous nephrolithotomy (PCNL) is routinely performed using fluoroscopic guidance with the patient in a prone position. We compared ultrasonography-guided access for PCNL with the patient in the flank position with conventional fluoroscopy-guided access. PATIENTS AND METHODS: A total of 60 patients were randomly separated into two 30-patient groups--namely, ultrasonography-guided access with the patient in the flank position as group 1, and fluoroscopy-guided access with the patient in the prone position as group 2. In group 1, the entire procedure was performed under ultrasonography guidance. RESULTS: Successful access was achieved 100% in both groups. The success rate was 86.7% in group 1 and 90% in group 2 (P = 0.45). The residual stone rate (stone >or=4 mm) was 13.3% in group 1 and 10% in group 2. The access duration was 14.5 +/- 2.6 minutes and 9.4 +/- 2.3 minutes in groups 1 and 2, respectively (P < 0.05). No significant differences for complications without any adjacent injuries were detected in both groups. Furthermore, the average hospital stay was 2.7 +/- 0.3 and 2.9 +/- 0.3 days accordingly for groups 1 and 2 (P = 0.89). CONCLUSION: Ultrasonography has a high ability to access calculi more easily through the pyelocaliceal system with the patient in the flank position. It is convenient for urologists, and the return to the supine position is possible easily when necessary. Besides, PCNL under ultrasonography guidance and with the patient in the flank position has high success rates and limited complications; hence, we recommend this technique as an alternative procedure for fluoroscopy-guided PCNL.

Endobronchial leiomyoma; report of a case successfully treated by bronchoscopic resection.

Bronchial leiomyoma is extremely rare. To date less than 60 cases have been reported in the world literature. The presented case here is a 30 year old woman who had been treated for bronchial asthma for several years. Her chest radiograph showed bulluos emphysematous changes in the right lung and computer tomography scan found the tumor in the right main bronchus near carina. Diagnosis was made by histological and immunohistochemical examination of the specimens obtained during bronchoscopy. The patient was treated by bonchoscopic resection of the 3 centimetre firm tumor and its removal through a tracheostomy incision.

Pattern of glomerulonephritis in Iran: a preliminary study and brief review.

BACKGROUND: Glomerulonephritis is a relatively rare disease with numerous subtypes and limited numbers of patients with each. Comprehensive epidemiological surveys are therefore difficult to undertake and there are few data on the spectrum of renal disease, especially in Iran. The aim was to determine the pattern of glomerulonephritis in Iran. MATERIAL/METHODS: Following a retrospective study on 400 candidates for renal biopsy whose renal specimens were evaluated at the pathology department of Tehran's referral hospital during 2006 and 2007, 393 cases were registered. The biopsy specimens were processed for light and electron microscopy and one renal pathologist confirmed these diagnoses using standard diagnostic criteria. RESULT: The mean +/-SD patient age was 31.9+/-15.9 (range: 3-78 years). Primary glomerulonephritis included 276 (70.2%) patients and 81(20.6%) had secondary glomerulonephritis. Of the 393 cases, 54.7% were male, 15.0% were children, and 3.8% were elderly. The most common glomerulonephritis was FSGS (37.1%) followed by MGN (16.5%) and lupus nephritis (13.4%). Furthermore, FSGS was the most common glomerulonephritis in the males (34.4%) and in all age groups. CONCLUSIONS: These data make a small contribution to the epidemiology of glomerulonephritis in Iran, showing an epidemiological difference from a previous study in Iran and other Middle East countries, particularly an increasing prevalence of focal and segmental glomerulosclerosis. A multi-center study with a larger sample size should be performed to create an Iranian registry of renal biopsies.

Supracrural rerouting as a technique for resolution of posterior urethral disruption defects.

INTRODUCTION: Selection of an acceptable method for the treatment of posterior urethral disruption defects would be highly desirable. We determined the efficacy and success rate of some techniques including supracrural rerouting for removing of these defects among our patients. MATERIALS AND METHODS: Records of 200 consecutive men treated with anastomotic urethroplasty for traumatic posterior urethral strictures were reviewed at our teaching hospital. Prior treatment, surgical approach, and ancillary techniques required during reconstruction were evaluated. RESULTS: Success rate due to posterior urethral reconstruction was achieved in 78.0% of cases. Supracrural urethral rerouting was performed in 11 patients (5.5%), of whom 7 sustained recurrent stricture requiring intervention. The highest success rate of defect resolving was reported by urethral mobilization (92.4%). CONCLUSION: Supracrural rerouting is not an acceptable technique and can result in postoperative complications such as recurrent stricture in most of the patients with posterior urethral disruption defects.

Desmopressin as an alternative solution for urinary leakage after ureterocaliceal surgeries.

INTRODUCTION: Persistent urine leakage is common following iatrogenic urinary collecting system injuries. Management of a urine leak usually includes manipulations such as catheter drainage, ureteral stenting, and percutaneous nephrostomy placement. The aim of this study was investigation the potential beneficial effect of desmopressin in reduction of urinary leakage duration. MATERIALS AND METHODS: Fifteen patients with incisional urinary leakage were enrolled in this study. They had undergone pyeloplasty (n = 9), pyelolithotomy (n = 4), and ureterocaliceal anastomosis (n = 1). All of them had ureteral stenting or nephrostomy catheters, and urinary leakage had lasted for at least 15 days. Seven patients received desmopressin spray, 1 puff, twice a day, from the 16th days of urinary leakage, and 8 patients (control group) did not receive any medical treatment. The duration of urinary leakage was compared between the two groups. RESULTS: The patients were 5 women and 10 men with the median age of 37 years (range, 26 to 58 years). None of the patients had urinary obstruction. There were no significant differences in age and sex distribution between the two groups. The mean urinary leakage duration was 28.7 +/- 7.2 days in the patients of desmopressin group and 47.7 +/- 8.8 days in those of the control group (P = .04). CONCLUSION: Our study showed that desmopressin can reduce the duration of incisional urinary leakage. We conclude that patients with prolonged urinary leakage after pyelocaliceal surgery who does not respond to surgical urinary drainage may benefit from desmopressin.